NOTRE DAME OF DADIANGAS UNIVERSITY

Marist Avenue, General Santos City

College of Education and Health Sciences

Name: Andre Jude B. Galanto Section: BSN 2A

CHN

Exercise 1:

1. What is epidemiology?
- The method of epidemiology is used to identify the root causes of diseases and other health
issues in populations. In epidemiology, the population as a whole is seen as the patient. Epidemiology
is defined as the scientific, systematic, and data-driven study of the distribution (frequency, pattern),
determinants (causes, risk factors), and occurrences associated to health in certain populations
(neighborhood, school, city, state, country, global). Also, this study's usefulness to the prevention and
treatment of health issues

2. Fifty percent of malaria cases occurred in North Zone. This statement shows, please choose
the best:
a) The distribution of malaria
b)v The causes of malaria
c) The time of the year when malaria is prevalent
3. Is epidemiology important to know the causes of malaria epidemic in your area?
- Yes, Epidemiology is crucial for learning about the factors that contribute to the spread of
malaria in our area or any areas for a variety of reasons. Researchers can determine the risk factors and
origins of malaria in a certain region by performing epidemiological studies, which can then be used to
inform public health initiatives and build strategies to prevent and manage the disease. For instance, if
epidemiological research shows that a specific species of mosquito is the source of dengue, zika virus or
malaria transmission, certain interventions can be done in order to reduce the disease on the findings for
example, wearing long-sleeves, stream seeding, stream clearing or other interventions/solutions.
Additionally, by monitoring the occurrence and prevalence of the disease over time, epidemiologists can
evaluate the effectiveness of interventions and pinpoint regions where additional malaria control efforts
may be required.

Exercise 2:
Identify the primary causes and risk factors for the following diseases:
Disease Primary Cause Environmental Risk
Host Risk Factors
Factors
Malaria Plasmodium Natural: temperature,  Age: Those under 5
rainfall, humidity; years and pregnant
elevation/slope; soil woman
quality; vegetation;  Weak Immune
hydrology; presence of Systems
natural enemies of  Genetics: Those with
mosquitoes and larvae; sickle cell trait or
natural disasters thalassemia are less
BSN 2A | GALANTO, ANDRE JUDE B.

Human-made: likely to develop

urbanization; land severe malaria
change/use; housing  Behavior: sleeping
type; deforestation; outdoors, not using
infrastructure (water, protecting measures
waste collection,  Co-morbidities: with
sanitation); other health
development projects conditions
(dams, roads, oil
pipelines, mining,
railways, irrigation,
resettlement); disasters
facilitated by human
change
Tuberculosis Mycobacterium  Indoor air pollution  Weakened immune
Tuberculosis  Tobacco smoke systems or with
 Malnutrition immunodeficiency
 Overcrowded living disorders.
Conditions  Age: elderly
 Excessive alcohol individuals and young
use children.
 Genetics: family
history of TB or
certain genetic
mutations.
 Substance use:
tobacco, alcohol, or
other drugs.
 Socioeconomic status:
in poverty or with
limited access to
healthcare.
HIV/AIDS Human Physical  Unprotected sexual
Immunodeficiency  Drug injecting sites intercourse with an
Virus (retrovirus;  Trade and infected partner
lentivirus family) trafficking routes  Reusing HIV-infected
(drugs, sex, equipment for
humans) injecting drugs
 Sex work sites  Age: Those between
 Labour mobility, the age of 15 to 24,
urban and economic due to sexual
migration experimentation and
 Prisons and other factors
detention centres  Weakened immune
 Geographical systems, such as those
dispersal of with
population immunocompromising
 Refugee collecting conditions
and dispersal  Sexually transmitted
centres infections (STIs):
BSN 2A | GALANTO, ANDRE JUDE B.

Economic particularly those

 Cost of living and causing genital ulcers
health care or inflammation
 Economic  Sexual orientation:
regulation and Females due to
development gender-based
 Income generation violence, economic
 Public and health inequality, and limited
service revenue and access to education
spend and healthcare
 Informal local
economies
 Employment norms
and practices
 Economic
enterprise
Social
 Peer and social
norms
 Social and cultural
norms and values
 Community
attitudes
 National and
cultural identity and
nationalism
 Local policing
practices
 Gender and social
inequalities
 Community health
and welfare
services
 Stigmatisation and
marginalisation of
social groups
 Civil society and
societal
infrastructure
Ameobiasis Entamoeba Histolytica  Exposure to
infected individuals
 Drinking
contaminated or
untreated water
(.e.g lakes, wells,
streams, ponds)
 Alcoholism
 Pregnancy
 Immunosuppression
BSN 2A | GALANTO, ANDRE JUDE B.

(e.g. use of
corticosteroids or
active malignancy)
 Individuals with
recent sexual
history of
unprotected anal or
oral-anal contact
 Recent travel to
developing
countries
Measles Measles Virus  In temperate  Age: Those under the
climate: Winter age of five and over
season, 20
overcrowding.  Weakened immune
 Population density systems (e.g. with
& Movement.  HIV/AIDS, cancer, or
 Areas with low on imunosuppressive
vaccination medications)
coverage for  Vitamin A deficiency
measles  Pregnancy
 Poor sanitation,  Genetic factors
including open
defecation and lack
of access to clean
water
Common Cold Rhinovirus  Crowded Spaces  Age: Particularly
 Shared surfaces those under the age of
 Sanitary conditions six, but all ages are
 Poor ventilation in susceptable to it
closed spaces  Weakened immune
 Secondhand systems (e.g. with
smoking HIV/AIDS, cancer, or
on
immunosuppressive
medications)
 Chronic illnesses (e.g.
asthma, diabetes)
 High levels of stress
and smoking
 Certain Genetic
Factors
BSN 2A | GALANTO, ANDRE JUDE B.

Exercise 3:
1. A patient with tuberculosis is treated with drugs. Is it possible to learn (know) the natural history
of tuberculosis on this patient? Why?
- It is possible to learn about the natural history of tuberculosis in a patient who is being
treated
with drugs, but the information obtained may be limited. It is because while treatment with drugs can
effectively cure tuberculosis, it may also alter the natural history of the disease by suppressing the
symptoms and preventing further transmission. However, the patient's medical history and response to
treatment can still provide valuable information about the natural history of tuberculosis. In addition,
studies that follow patients with tuberculosis over time, including those who have received treatment, can
provide valuable information about the natural history of the disease and the impact of treatment on
disease progression and outcomes. These studies can help inform the development of more effective
treatment strategies and public health interventions aimed at controlling and eliminating tuberculosis.

2. Write the primary, secondary, and tertiary prevention strategies for the diseases or conditions
listed in the table below.

Secondary
Disease Primary Prevention Tertiary Prevention
Prevention
Measles  Immunization/Vaccination  Quarantine of  Symptomatic
 Good Hygiene susceptible treatment:
Practices contact. supportive care to
 Avoiding places  Isolation of manage
experiencing active measles symptoms
symptoms of cases;  Vitamin A
measles  Special supplementation:
vaccination reduce risk of
clinics or complications and
activities during improve
outbreaks to outcomes
increase  Antibiotics for
population bacterial
immunization complications:
coverage prevent secondary
bacterial
infections (e.g
pneumonia, ear
infections)
 Isolation: prevent
spread
 Education and
counseling: about
disease,
transmission, and
importance of
vaccination
 Vaccination:
prevent and
reduce severity of
measles and its
BSN 2A | GALANTO, ANDRE JUDE B.

complications
Pulmonary  BCG Vaccine  Contact tracing  Directly Observed
Tuberculosis  TB Screening and for early Therapy (DOT):
Testing: Tuberculin skin detection and ensure adherence
test and Interferon gamma diagnosis to full course of
release assays (IGRAs)  Treatment of treatment
latent  Chest
tuberculosis physiotherapy:
infection and clear lungs of
active mucus and
tuberculosis improve breathing
 Education and  Nutritional
counseling: about Support &
the disease, its Supportive care to
transmission, and strengthen
importance of immune system
adherence to and manage
treatment symptoms.
 Rehabilitation: to
regain strength
and function after
severe case of TB
 Regular follow-up
care: monitor
treatment
progress and
detect
complications or
recurrence
A person lost his  Increase public awareness  Proper Infection  Rehabilitation:
leg by car accident of the need for safe Control Measures physical therapy,
driving habits and the  Pain occupational
risks associated with Management and therapy, and other
irresponsible driving Psychological specialized
 Antilock brakes, airbags, Support therapies.
electronic stability  Instruction and  Pain management
control, and lane departure counseling are and psychological
warning systems should provided to the support.
be implemented for patient and their  Support for
vehicle safety measures. caretakers on nutrition: dietary
 Criteria for driver's how to take care advice or
education, training, and of themselves, supplements.
licensing how to use  Wheelchairs,
prosthesis canes, crutches,
properly, and and other assistive
how to deal with equipment.
the difficulties of
living with an
amputation.
Poliomyelitis  Reaction to an outbreak:  Early detection  Rehabilitation: to
BSN 2A | GALANTO, ANDRE JUDE B.

immunization drives and and treatment: regain mobility

public health messages. reduce the and function.
 Improved Hygiene and severity of the  Pain management
Sanitation disease and avoid and psychological
 Inacctivated Polio consequences. support.
Vaccine (IPV) or Oral  Education and  Nutritional
Polio Vaccine (OPV) counseling Support: dietary
regarding counseling or
illnesses and how supplements.
to stop them from
spreading
 Isolation: prevent
spread of the
virus

Exercise 4:
Identify the components of the chain of transmission for the following diseases:

Chain of
Malaria Amoebiasis Tuberculosis
Transmission
I. Infectious Agent Plasmodium parasite Entamoeba Mycobacterium
histolytica tuberculosis
Humans; certain
Humans, Humans,
Plasmodium species
II. Reservoir particularly in the particularly those
can also infect other
large intestine with active
animals such as
pulmonary TB
monkeys
Bloodstream through
III. Portal of Exit infected female Human Feces Human Respiratory
Anopheles mosquito Tract
bite
Infected female
Anopheles mosquito Air Transmission:
Fecal-Oral
bite, blood Expelled droplets
IV. Mode of Transmission,
transfusions, organ with M. tuberculosis
Transmission Direct Contact with
transplantation, or through coughing,
Fecal Matter
sharing of sneezing, or speaking
contaminated needles
Bloodstream through
infected female Mouth Human Respiratory
V. Portal of Entry
Anopheles mosquito Tract (Inhalation)
bite
Humans, particularly
Humans, particularly
those with weakened
Humans, particularly those with weakened
immune systems and
VI. Susceptible Host pregnant women and immune systems or
on immunosuppressive
young children poor hygiene
therapy or history of
practices
substance abuse
BSN 2A | GALANTO, ANDRE JUDE B.

Exercise 5:
1. Suppose you want to determine the prevalence of hypertension among adult population in
your area. How do you conduct a cross sectional studies for this purpose?

Conducting a cross-sectional study follows the following procedure:

a) Gather data on the total amount of population given in the criteria.
b) Choose a sample of the study population that has the most appropriate criteria for data
gathering. It must to be sizable enough to produce results that are statistically significant.
c) Create a survey to gather information about several aspects of hypertension, including
age, gender, medical history, lifestyle choices (such as smoking, drinking, and physical
activity), family history, and medication use.
d) Obtain an informed consent from the participants of the study for legal purposes and
inform them about the purpose of the study and its use.
e) Data gathering by conducting a survey from the participants from the selected population
using a structured questionnaire.
f) Data analyzation to determine the prevalence of hypertension in the selected population.
g) Consider the study population and any study limitations when interpreting the findings.
To assess whether the prevalence of hypertension is higher or lower than anticipated, it
can be compared to other populations.
h) Report the results, mentioning the prevalence of hypertension and any risk factors. The
findings can be utilized to create public health initiatives to lower the incidence of
hypertension in the population under study.

Choose the best answer for questions 2, 3, and 4.

2. Malaria mainly affects children. This is:
a) Distribution by person
b)v Distribution by place
c) Distribution by time
3. Pregnant women are highly affected by malaria. This is:
a) Distribution by person
b)v Distribution by place
c) Distribution by time
4. Epidemic of malaria occurs in October, November, and April. This is:
a) Distribution by person
b) Distribution by place
c) Distribution by time
v
Exercise 6:
The following information is about Barangay X which was collected for the year 2015:

 Total average population = 40,000

 Total number of live births = 4000
 Total number of deaths = 400
 Total number of deaths before the age of 28 days = 50
 Total number of infant deaths = 200
 Number of women who died from pregnancy related causes = 160
 New cases of tuberculosis = 100
 All cases of tuberculosis = 300
 Deaths from tuberculosis = 60
BSN 2A | GALANTO, ANDRE JUDE B.

Based on the above information calculate the following.

1. The incidence rate of tuberculosis.
100
¿ x 10 , 00 0
40,000
¿ 0.0025 x 1 0 , 000
¿ 25

Conclusion: That means out of every 10,000 people, 25 of them acquired new cases of
tuberculosis.

2. The period prevalence rate of tuberculosis.

300
¿ x 10 0
40,000
¿ 0.0075 x 1 00
¿ 0.75

Conclusion: That means 0.75% of the people we’re affected by tuberculosis.

3. The case fatality rate of tuberculosis.

60
¿ x 1 00
300
¿ 0.2 x 100
¿ 20

Conclusion: That means 20% of tuberculosis patients will die once they develop the disease.

4. The Neonatal mortality rate.

50
¿ x 1,00 0
4 , 000
¿ 0.0125 x 1,000
¿ 12.5

Conclusion: That means out of 1,000 live births, 13 of them died before 28 days after birth.

5. The infant mortality rate.

200
¿ x 1,00 0
4 , 000
¿ 0.05 x 1,000
¿ 50

Conclusion: That means out of 1,000 live births, 50 of them died before 1 year of age.

6. The maternal mortality ratio.

160
¿ x 1,00 0
4 , 000
¿ 0.04 x 1,000
¿ 40
BSN 2A | GALANTO, ANDRE JUDE B.

Conclusion: That means out of 1,000 live births, 40 of them died due to pregnancy associated
deaths.
Exercise 7

1. State the different sources of health information.

 Census
 Vital Statistics
 Health Service Records
 Health Surveys
2. Discuss the problems related to health service records as source of health data.
- Health care records may contain incomplete or inaccurate information, which can cause
mistakes in the analysis and interpretation of the data. Errors in data entry: Since health
service records are frequently completed by hand, they may contain mistakes from illegible
handwriting or typos. Data standardization: Because different health facilities or areas may
use different terminologies or coding systems in their records, it can be challenging to
compare data between them.
3. If you want to know the number of people in your barangay who are properly using latrines,
which method of data collection would be appropriate?
- Finding out how many people use the latrines in a barangay is best done through a census. By
conducting a census, we can clearly identify the social, economic, and demographic traits of
the barangay's latrine users. This technique for gathering data yields the necessary
information. Censuses gather demographic information about people and their residences. A
census of every type of residence is also available. A list of people and all of their residences
is also possible. Also, it encompasses everyone who resides in a particular region.

Exercise 8

1. Hundred cases of malaria were seen in the health post which is found in your kebele in October
2000. Can you say there was epidemic of malaria in October 2000? Why?
- We can say that there was an epidemic of malaria in October 2000 in our kebele if we
compare the historical data of the kebele and the population in October 2000. We can say that
there was an epidemic if the number of cases of malaria in October 2000 is much higher than
we normally anticipated or base on normal factors. We cannot, however, tell with certainty
whether there was a malaria epidemic in the kebele in October 2000 without this context and
more details. To ascertain the scope, temporal trend, and geographic distribution of the
malaria cases, as well as to compare the actual cases to what would be anticipated given
historical data and population characteristics, a detailed epidemiological research is required.
2. Suppose epidemic of common cold occur in your area. What type of epidemic is this one?
a) Point source epidemic
b) Common source epidemic with continued exposure
c) Propagated epidemic
v
d) Mixed epidemic
3. Suppose epidemic of relapsing fever occur in your area. What type of epidemic is this one?
a) Point source epidemic
b) Common source epidemic with continued exposure
c) Propagated epidemic
d)v Mixed epidemic
4. Ten patients come to you to seek treatment because they have fever and severe headache. They
also informed you that there are many other similar cases in their village. How do you investigate
BSN 2A | GALANTO, ANDRE JUDE B.

this epidemic?
- To hasten this assessment during the epidemic, form a research or health team. Confirming
the diagnosis and getting information from victims are critical steps in determining the
presence of an epidemic. Clinical laboratory tests such as CBC and urine may be utilized to
assist with this. In order to tally the occurrences, it is important to interview patients who
show indicators of the condition after it has been identified. The next stage in stopping or
slowing virus transmission is to pinpoint the source of the outbreak. Following that, we
educate them on the epidemic as well as the necessity of adequate sanitation, hygiene, and
water quality.

5. Suppose malaria epidemic occur in your kebele. How do you control it?
- If there was a malaria epidemic occurring, the first thing to do is advice people on the
prevention of malaria. We can protect ourselves by wearing long-sleeves and pants as well as
by doing stream-clearing, stream-seeding, destruction of the mosquito habitat and etc. The
major current strategies are to reduce human contact with mosquitos, to eliminate larvae by
environmental management and the use of larvicides or mosquito larvae predators, and to
eliminate adults through indoor residual spraying and insecticide-treated bed nets. Malaria
transmission occurs primarily at night since the vast majority of Anopheles mosquitoes feed
at night. Teach the population about the signs and symptoms of malaria, the necessity of
getting a diagnosis and treatment as soon as possible, and how to avoid mosquito bites. It is
vital to highlight that controlling a malaria epidemic involves long-term efforts because the
illness can easily re-emerge if control measures are loosened. As a result, it is critical to
continuously monitoring the situation and altering the reaction as needed in order to establish
long-term control of the epidemic.

Exercise 9

1. What is the purpose of surveillance?

- Surveillance is the systematic collection, analysis, and interpretation of data in order to
monitor trends, detect outbreaks, and advise public health measures. Surveillance enables
early detection and response to public health problems such infectious illnesses,
environmental dangers, and other health issues.
2. What is the difference between active and passive surveillance?
- Passive surveillance is a routine surveillance strategy based on passive case detection and a
routine recording and reporting system. The information provider seeks assistance from
health institutions, whether medical or other preventative and promotional health services. It
entails data collection as part of ordinary health-care delivery.
- Active surveillance is a means of collecting data about a specific disease over a very short
period of time. It entails gathering data from communities, such as through house-to-house
surveys, or mobilizing communities to a central location where data can be gathered. This can
be accomplished by delegating health staff to gather data on the presence or absence of new
instances of a specific disease at regular intervals.
3. What is the most important use of active surveillance?
- Active surveillance is a technique used in medicine to monitor people who are at a higher risk
of getting a specific disease or condition. The most essential application of active monitoring
is detecting early indicators of disease and intervening before the condition worsens.
4. What are the activities in surveillance?
- The actions that are engaged are determined by the kind and scope of the surveillance. One
frequent surveillance activity is data collection, which entails gathering information on a
certain disease, condition, or event that is being monitored. This may necessitate the
acquisition of test results, medical records, and other pertinent data. The process of looking at
BSN 2A | GALANTO, ANDRE JUDE B.

collected data to uncover patterns or trends that could signal an epidemic or a shift in the
incidence or prevalence of a specific disease or condition is known as data analysis.
Reporting: Disseminating the surveillance results to the appropriate authorities, such as
public health organizations, healthcare providers, and other interested parties.
5. What is the advantage of integrated disease surveillance strategy?
- Early disease outbreak detection: By merging data from several sources, IDSS can detect
disease outbreaks early on, allowing for rapid intervention and control measures. IDSS can
increase disease surveillance accuracy by cross-referencing information from diverse sources
and looking for anomalies or contradictions. The use of IDSS can enable a more coordinated
and effective response to disease outbreaks, with multiple agencies and stakeholders working
together to find a solution. Improved resource distribution: By focusing on the locations and
populations most vulnerable, IDSS can aid in the deployment of resources such as medical
personnel, diagnostic instruments, and immunizations. Improved outcomes for public health.
Response: Taking action in response to the findings of the surveillance, such as implementing
control mechanisms, educating the public, or launching a fresh investigation. Evaluation:
Assessing the efficiency of surveillance activities to identify areas for improvement and
maximize future surveillance operations.